Turk Kardiyol Dern Ars. 2015; 43(6): 542-550 | DOI: 10.5543/tkda.2015.52498

Pulmonary and ventricular functions in children with repaired tetralogy of Fallot

Savaş Demirpençe¹, Barış Güven², Murat Muhtar Yılmazer³, Taliha Öner³, Önder Doksöz³, Rahmi Özdemir³, Hikmet Tekin Nacaroğlu⁴, Timur Meşe³, Vedide Tavlı¹, Demet Can^4
1Sifa University Faculty of Medicine, Department of Pediatric Cardiology, Bornova, Izmir, Turkey
²Izmir University Faculty of Medicine, Medical Park Hospital, Department of Pediatric Cardiology, Karşıyaka, Izmir, Turkey
³Behçet Uz Children Hospital, Departments of Pediatric Cardiology, Alsancak, Izmir, Turkey
⁴Behçet Uz Children Hospital, Departments of Pediatric Allergy and Immunology, Alsancak, Izmir, Turkey

OBJECTIVE
This study aimed to evaluate biventricular function, brain natriuretic peptide levels, respiratory function test and 6 minute walking test (6MWT) in children with repaired tetralogy of Fallot (TOF), and analyse the correlation between these variables and clinical status.

METHODS
Twenty-five children (14 boys, 11 girls; aged 6 to 17 years) with repaired TOF (Group 1) and 25 age-sex matched healthy controls (Group 2) were enrolled in the study. Tissue Doppler echocardiography, respiratory function test, 6MWT distance and brain natriuretic peptide levels were measured.

RESULTS
Mean ages of the children at TOF corrective surgery and at study time were 5.1±3.5 years and 11.6±2.7 years respectively. The duration between palliative operation and corrective surgery was 4.3±2.0 years, and the follow-up period after corrective surgery was 6.3±3.0 years. The right ventricular and left ventricular myocardial performance indices (MPIs), and isovolumic relaxation and contraction times were significantly higher in Group 1 than in Group 2 (p<0.01). Spirometry displayed significantly reduced forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow 25–75% (FEF25–75) and inspirational capacity in Group 1 compared to Group 2 (p<0.01). In Group 1, 6MWT distances were significantly lower than in Group 2 (p=0.001). Right ventricular MPI is correlated with FEV1, FVC and 6MWT distance in the current study.

CONCLUSION
The children with repaired TOF had impaired ventricular and pulmonary functions. Hence, right ventricular MPI along with FEV1, FVC and 6MWT distance may be useful in the follow-up of children with repaired TOF.

Keywords: Natriuretic peptide, brain, tetralogy of Fallot, tissue Doppler echocardiography, six minute walking test; respiratory function test

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